In the United States, heart failure (HF) affects 6 million persons (Yancy 2013). HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) each affect 3 million people. The lifetime risk of developing HF is 1 in 5 for men and women older than 40 years of age. The death rate remains unacceptably high at approximately 50% within 5 years from the time of index diagnosis. In the US, an annually estimated 300,000 persons are diagnosed with Stage D heart failure, also classified as advanced heart failure (AdHF) (Hunt 2009).